Medicare denying ambulance claims

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LAMARâ Marie Buhrer who handles billing for the Lamar Fire and Ambulance service is working to get the word out to Medicare patients who could find themselves owing $434 to the ambulance service if Medicare determines their transport by ambulance was not a medical necessity.

Buhrer said she is particularly concerned about the impact such a bill could have on those who already have limited means to cover medical expenses. With that in mind, she has recently been sending letters out to places where older citizens reside, such as apartment complexes, nursing homes and assisted living facilities, in hopes the administrators there will pass along this important information to their residents.

According to Buhrer, the ambulance service is always willing to bill insurance, including Medicare, but cannot just absorb the cost of claims that are denied for one reason or another.

She said the service advises those whose condition does not necessitate ambulance transport that it is likely the claim will be denied so they can make an informed decision about whether to opt for a trip by ambulance or perhaps seek assistance with getting to the hospital from a friend or relative. Whether or not the patient chooses ambulance transport, they will be asked to sign a form acknowledging they have been advised they will be responsible for the bill if Medicare does not pay the claim.

Buhrer said she sympathizes with anyone who is ill and isn’t sure if they need to call the ambulance or not. She agreed that sometimes, especially with patients who have certain medical conditions, it may not be clear whether the ambulance is needed or not. Generally though, if specific emergent treatment is not given during the ambulance transport, the claim will be denied.

“We just want to let people know,” she said, adding that she hopes the publicity will make people more aware of the situation before something happens and they are faced with a decision about calling the ambulance service.